Pap Test

What Is a Pap Test?

A Pap test is a test of a sample of cells taken from a woman's cervix or vagina. The test is used to look for changes in the cells of the cervix or vagina that show cancer or conditions that may develop into cancer.

It is the best tool to detect precancerous conditions and hidden, small tumors that may lead to cervical cancer. If detected early, cervical cancer can be cured.

Make sure you get a Pap test to check for cervical cancer every 3 years if you are 21 or older. If you are age 30-65, you can get both a Pap test and HPV test every 5 years. Older than that, you may be able to stop testing if your doctor says you're low risk. If you are sexually active and have a higher risk for STDs, get tests for chlamydia, gonorrhea, and syphilis yearly. Take an HIV test at least once, more frequently if you’re at risk.

How Is a Pap Test Performed?

The Pap test is done during a pelvic exam. A doctor uses a device called a speculum to widen the opening of the vagina so that the cervix and vagina can be examined. A plastic spatula and small brush are used to collect cells from the cervix. After the cells are taken, they are placed into a solution. The solution is sent to a lab for testing.

Is the Pap Test Painful?

A Pap test is not painful but may be a little uncomfortable.

When Will I Know the Results of the Pap Test?

It generally takes about a week to get the test results. If you haven't heard from your doctor's office after three weeks, give them a call to see if your results have come back.

What Do the Results of a Pap Test Mean?

A normal Pap test means the cells from the cervix look normal. An abnormal Pap test means the cells do not look normal. Sometimes repeat Pap tests are needed. Different tests also may need to be done, such as a colposcopy (the use of a special microscope to examine the cervix and vagina). Pap tests can occasionally show signs of infection but cannot be relied on to screen for sexually transmitted diseases (STDs). Other tests are necessary to determine the presence of an STD. There are several things you can do to help make the Pap test as accurate as possible. These include avoidance of sex, douching, and vaginal creams for 48 hours before the test.

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What Happens If the Results Are Abnormal?

An abnormal Pap test does not necessarily mean that cancer cells were found during the examination. There are many causes for abnormal Pap test results, including infection, inflammation related to using a diaphragm or sex, and changes related to your menstrual cycle. Your doctor will evaluate the results to determine if further testing is necessary.

Why Would I Need to Repeat the Pap Test?

A repeat Pap test may be necessary if there were not enough cells collected during the test. Since decreased levels of the female hormone estrogen also can influence Pap test results, menopausal women may need to take estrogen before they repeat the test. This is not an abnormal result but is called unsatisfactory for evaluation.

What Is a Colposcopy?

Colposcopy is an examination of the cervix and the walls of the vagina. During the examination, a speculum is inserted into the vagina (as done in a Pap test). Your doctor looks through a magnifying instrument called a colposcope to detect cervical and vaginal problems that cannot be seen by the eye alone. During the colposcopy, the colposcope remains outside the vagina. Biopsies (tissue samples) of the abnormal cervical or vaginal area may be taken.

Colposcopy is not always necessary immediately after an abnormal Pap test. Be sure to ask your doctor about other options.

How Often Should I Get a Pap Test?

Get a pap test to check for cervical cancer every 3 years if you are 21 or older. If you are age 30-65, you can get both a Pap test and HPV test every 5 years. Older than that, you may be able to stop testing if your doctor says you're low risk.

Women with certain risk factors, such as being HIV positive (carrying the virus that causes AIDS), a weakened immune system due to chemotherapy, organ transplant, chronic steroid use, have a history of diethylstilbestrol (DES) exposure before birth or have had a history of abnormal Pap tests, should continue to be screened more frequently.

If you are sexually active and have a higher risk for STDs, get tests for chlamydia, gonorrhea, and syphilis yearly. Take an HIV test at least once, more frequently if you’re at risk.

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What Symptoms Should I Watch for Between Pap Tests?

Precancerous conditions of the cervix seldom cause symptoms. For problems to be detected, a pelvic examination and a Pap test are usually required.

When cancer is present in the cervix, the most common symptom is abnormal bleeding. Bleeding may start and stop between regular menstrual periods, or it may occur after sexual intercourse or douching. Abnormal vaginal discharge is another symptom. Pain is NOT an early warning sign of the disease. These symptoms are not sure signs of cancer. But be sure to see your doctor if any of these symptoms develop.

Do I Need to Get Pap Tests if I Have Had a Hysterectomy?

Most doctors would recommend that you continue to have Pap tests after a total hysterectomy (removal of the uterus and cervix), especially if you have a history of cervical pre-invasive or invasive cancer or other uterine cancers because you are still at risk for vaginal cancer. Women who have had a partial hysterectomy with the cervix remaining should continue to have routine Pap tests. Check with your doctor to determine if you still need Pap tests. Even women who no longer require Pap tests should see their doctor annually for pelvic exams.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on December 01, 2015

Sources

SOURCES:

American Cancer Society.

American College of Obstetricians and Gynecologists. 

National Cancer Institute.

US Preventive Services Task Force.

 

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